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As a Director of Network COGS Strategy, you will support critical PBM initiatives aimed at developing Network contracts that best meet regulatory, plan sponsor and member needs. In this high visibility leadership role, you will be responsible for supporting the Network Contract team, handle complex analyses on network improvements, drive executional excellence in managing UW COGS assumptions, and manage a team of 3 analysts. You will work closely with senior executives and business partners at all levels of the organization to help formulate solutions and present recommendations.
Job Responsibility:
Support development and expansion of provider networks by evaluating potential providers and their contract terms
Contribute to optimizing the network's performance and effectiveness by analyzing network data, utilization patterns, and market trends to identify opportunities for network enhancements, cost savings, and improved access to care
Monitor the performance of network providers including tracking key performance indicators
Conduct market analysis, assess competitive landscapes, and make recommendations for network expansion strategies
Communicate findings to executive leadership and stakeholders
Manage operational aspects of the team, subsequently implementing workforce and succession plans to meet business goals and objectives
Requirements:
At least 10 years of experience within healthcare or related industries
Minimum 5 years contracting, PBM Network negotiation, PBM pricing or consulting experience
2 years or more of people leadership experience
Bachelor's degree from an accredited college is required
Nice to have:
MBA or relevant Master's degree
Demonstrated ability to influence and drive change in a complex business environment
Understanding of pharmacy provider contracting and PBM Underwriting
Competent in Excel and other data analytics tools
What we offer:
Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching